Conectar
The roles of pharmacy staff have expanded to include public health functions, such as delivering harm reduction services for people who use drugs (PWUD), particularly unregulated substances and non-medical drug use, in response to an ongoing drug overdose crisis. Nonetheless, their involvement across the full spectrum of harm reduction services remains underexplored. This study mapped existing research describing or evaluating the implementation of harm reduction services for PWUD provided by pharmacy staff.
Scoping review.
MEDLINE, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (inception to July 2025).
Studies reporting on the description or evaluation of harm reduction services for PWUD provided by pharmacy staff.
Two team members screened studies for eligibility and extracted the data. The data were analysed primarily to describe harm reduction services and the role of pharmacy staff.
43 articles were included. The most frequently reported harm reduction services were sexually transmitted and blood-borne infection care (33%), needle and syringe programmes (21%), naloxone distribution (19%) and medication treatment for opioid use disorder (19%). Pharmacy staff were integrated into multidisciplinary teams (79%), with their roles varying from education to medication prescribing. Included studies reported harm reduction services for PWUD delivered by pharmacy staff as effective, feasible and safe. However, implementations were not tailored to equity-deserving populations. Services primarily addressed opioid-related harms, while strategies focusing on the use of non-opioid substances were limited.
This scoping review highlights the diverse roles pharmacy staff play in delivering harm reduction services for PWUD. Positioned at the intersection of accessibility and healthcare delivery, pharmacy staff are ideally situated to expand access to equitable care. To fully harness this potential, future research and practice should embed harm reduction as a core philosophy, extending beyond individual interventions to support the creation of person-centred, non-judgmental and low-barrier services.
Onchocerciasis, commonly known as river blindness, is a parasitic disease caused by Onchocerca volvulus affecting millions predominantly in sub-Saharan Africa. Robust epidemiological evidence points to a clinical relationship between onchocerciasis and epilepsy, a condition termed onchocerciasis-associated epilepsy (OAE). Despite extensive research and various successful elimination programmes over the past decades, the pathogenesis of OAE is still unknown. Current hypotheses propose that O. volvulus microfilaria, their excretory-secretory products or the newly discovered filarial O. volvulus RNA virus 1 (OVRV1) virus may traverse the blood-brain barrier, triggering seizures or immune responses that result in neurological damage. However, direct evidence of microfilaria or their DNA in cerebrospinal fluid (CSF) or brain tissue remains elusive, likely due to immune-mediated parasite clearance. Additionally, investigations into the potential neurotoxicity of these novel filarial viruses have yet to be pioneered.
This prospective cohort study will involve 100 ivermectin-naïve children aged 2–5 years, recruited from rural communities in the Aketi health zone, located in the Democratic Republic of Congo. This region is known to be an onchocerciasis-endemic area with a high prevalence and transmission of OAE, despite years of community-directed treatment with ivermectin. Lumbar punctures (LP) will be performed in children presenting with complex febrile seizures according to WHO’s paediatric guidelines. CSF samples will be examined for white blood cells, protein levels, glycorrhachia, microfilaria, OVRV1 and O. volvulus biomarkers. Children will be followed annually, monitoring the development of epilepsy and O. volvulus infection. This approach aims to elucidate the presence of O. volvulus and OVRV1 in the brain and their role in the pathogenesis of epileptic seizures and the myriad of clinical symptoms observed in OAE.
The protocol has been approved by the Ethics Committee of the University of Kisangani (UNIKIS/CE/KGB/001/2025) and the University of Antwerp (project ID 7323-Edge n/a-BUN B3002025000078). Written informed consent will be obtained from all parents and/or legal guardians of children for whom an LP is considered. Findings will be disseminated at national and international levels via meetings and peer-reviewed open-source publications. Study data will be stored in an open repository.
Pan African Clinical Trials Registry (PACTR202507670131109).
The 2012 Kidney Diseases Improving Global Outcomes clinical practice guideline recommends prescribing continuous renal replacement therapy (CRRT) doses in patients with acute kidney injury (AKI) between 20 and 25 mL/kg/hour, with a need to consider further augmentation to 25–30 mL/kg/hour. Observational data have shown that lower-dose CRRT (
Ovid MEDLINE, Ovid Embase, CINAHL and Cochrane Library will be searched for studies from inception to present. We will evaluate the risk of bias using the modified Cochrane tool for randomised controlled trials and the Cochrane Risk of Bias In Non-randomised Studies—of Interventions tool for cohort studies. Two reviewers will independently complete study selection, data extraction and bias assessment. Inclusion criteria will be randomised controlled trials and observational studies (cohort) including patients with AKI receiving CRRT. The exposure will be lower dose-intensity CRRT (
Ethics approval is not required as primary data will not be collected. Findings of this review will be disseminated through peer-related publication.
CRD420251135606.
To develop an instrument for assessing competence in emerging infectious disease prevention among health and care workers in long-term care institutions and evaluate its psychometric properties.
A cross-sectional, descriptive design utilising both qualitative and quantitative methods was employed.
Based on scale development guidelines, the scale was developed in two phases, namely the scale development phase and scale testing phase, with the staff of long-term care institutions as the study population and their workplaces as the sampling unit.
The scale comprises 27 items across three dimensions: 14 items pertaining to professional role performance, 7 items addressing workplace resources, and 6 items focusing on soft skills in communication and collaboration. Content analysis was conducted via a focus group discussion; content validity analysis was carried out via expert reviews; item analysis was performed via a pilot study; and construct validity and reliability were ensured via factor analysis and internal consistency testing, respectively. The total variance explained by the three factors of the 27-item scale was 64.8%, demonstrating acceptable validity and reliability with a Cronbach's α value of 0.97.
This scale demonstrates excellent reliability and validity, making it suitable for clinical practice and research. In practice, this instrument could also assist managers in adjusting policies to adapt to dynamic situations and enhance the quality of care in long-term care institutions. Nonetheless, further research is warranted to refine the scale and enhance its generalisability.
The scale is a psychometrically robust tool tailored for the evaluation of competence in emerging infectious disease prevention in long-term care institutions. It assesses the role performance, workplace resources, and soft skills of health and care workers in these institutions, which are crucial for guiding educational interventions and shaping policies to enhance disease prevention, ultimately improving care quality.
No patient or public contribution.
Sickle cell disease (SCD) is associated with significant mortality and morbidity, especially in low- and middle-income countries.
We determined the indications for hospitalisation and predictors of 30-day re-admission among patients with SCD in Northern and Central Uganda.
Retrospective chart review.
Mulago National Referral Hospital in Kampala, St. Mary’s Hospital Lacor in Gulu and Gulu Regional Referral Hospital in Gulu, Uganda.
Patients with confirmed SCD admitted between January 2020 and January 2025 were included.
Primary outcome: indication for hospitalisation. Secondary outcomes: rate and predictors of 30-day hospital re-admission. Socio-demographic, clinical history and hospitalisation data were extracted using a pretested data extraction tool.
We enrolled 505 patients, accounting for 714 hospital admissions, with a mean age of 8.1±6.2 years. Most participants (n=489, 96.8%) had less than four admissions per year, with a median of 1 admission (IQR: 0–2). The most common indications for hospitalisation were infection (n=375, 52.5%), painful crisis (n=366, 51.3%) and anaemia (n=186, 26.1%). Malaria was the most prevalent infection (n=244, 65%). The median length of hospital stay was 4 days (IQR: 3–6), with a 30-day re-admission rate of 6.9% (n=49). Admission with painful crisis (adjusted OR (AOR): 0.45, 95% CI: 0.23 to 0.89, p=0.021), receiving a blood product (AOR: 0.32, 95% CI: 0.16 to 0.66, p=0.002) and having four or more admissions per year (AOR: 0.84, 95% CI: 0.04 to 0.17, p
Infections, especially malaria, and painful crises were the leading causes of hospitalisation among Ugandan patients with SCD. Frequent admissions, painful crises and blood transfusions were associated with lower 30-day re-admission risk. There is an urgent need to strengthen malaria prevention strategies and optimise access to disease-modifying therapy, such as hydroxyurea, to improve patient outcomes.
FreshRSS 